Document Detail


Septic versus aseptic hip revision: how different?
MedLine Citation:
PMID:  20811922     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The few available studies directly comparing aseptic and septic joint revision surgery report conflicting results. We investigated whether two-stage revision of septic hip prosthesis with a preformed antibiotic-loaded spacer and an uncemented prosthesis provides hip function and quality of life similar to those provided by aseptic revision surgery in the medium term, as well as the associated direct hospital costs.
MATERIALS AND METHODS: We prospectively evaluated the hip function (Harris hip score) and quality of life (WOMAC and SF-12 scores) of 80 patients who underwent one-stage revision for aseptic loosening (Group A, 40 patients) or two-stage revision for septic total hip prostheses (Group S, 40 patients). Patients were matched for gender, age, and bone loss. A preformed antibiotic-loaded cement spacer was used for two-stage revision, and uncemented modular prostheses were implanted at revision in both groups. The minimum follow-up was 2 years (average 4 years; range 2-6 years).
RESULTS: We found no difference in infection recurrence or aseptic loosening rate in the two groups. Average Harris hip score increased similarly in both groups: from 19.1 to 74.0 in Group A versus 15.0-71.2 in Group S. Patient-reported quality-of-life questionnaires (SF-12 and WOMAC) at last follow-up were similar postoperatively, but the complication rate for Group S was twice that of Group A (20.8 versus 10%). Mean overall hospital-related costs of two-stage procedures were 2.2 times greater than those for aseptic revisions.
CONCLUSIONS: Two-stage revision for infected hip prostheses, using a preformed antibiotic-loaded cement spacer and uncemented revision prosthesis, offers a success rate comparable to noninfected revisions in the medium term but is associated with a higher complication rate and costs.
Authors:
Carlo Luca Romanò; Delia Romanò; Nicola Logoluso; Enzo Meani
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-09-02
Journal Detail:
Title:  Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology     Volume:  11     ISSN:  1590-9999     ISO Abbreviation:  J Orthop Traumatol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-07     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101090931     Medline TA:  J Orthop Traumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  167-74     Citation Subset:  IM    
Affiliation:
Dipartimento di Chirurgia Ricostruttiva e delle Infezioni Osteo-articolari, Istituto Ortopedico IRCCS Galeazzi, 4-20166 Milan, Italy. carlo.romano@grupposandonato.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Bacterial Agents / administration & dosage*
Arthroplasty, Replacement, Hip / adverse effects*,  methods
Bone Cements
Cohort Studies
Female
Follow-Up Studies
Hip Prosthesis*
Humans
Italy
Joint Instability / etiology,  physiopathology,  surgery
Male
Middle Aged
Pain Measurement
Prospective Studies
Prosthesis Design
Prosthesis Failure*
Prosthesis Implantation
Prosthesis-Related Infections / drug therapy,  microbiology,  surgery*
Quality of Life*
Range of Motion, Articular / physiology
Reference Values
Reoperation / methods
Risk Assessment
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Bone Cements
Comments/Corrections

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